POLST is used now at some level in almost all counties in Pennsylvania. Shown below is an updated state map. If any reader has information on use in the seven white counties, please let us know.
National POLST set standards for recognizing POLST Programs as mature, endorsed, active, or unaffiliated. Pennsylvania is considered to be an “Endorsed” state as our program is actively participating in National POLST governance and has developed and implemented a POLST program form meeting National POLST standards. Standards include: a single form for the state or territory, program leadership diversity, addressing legal and regulatory issues related to POLST, and developing strategies for ongoing, statewide implementation, education and quality assurance.
POLST in Oregon
Oregon is unaffiliated at this time, due to a difference of opinion about National POLST’s Conflict of Interest Policy that allowed—in highly vetted circumstances—the ability to accept industry funding. National POLST’s policy is a commitment to transparency and inclusion for considering partnerships with those supporting its mission, vision and essential values and who are interested in helping people have access to quality POLST programs. National agrees with Oregon POLST that the purpose of POLST is to elicit, document and honor patient treatment wishes and that reducing costs is not a purpose of the form, and that patient participation in POLST must be voluntary.
Currently, four states provide a centralized POLST registry and about 16 states are actively working on the development of one. Pennsylvania is now among those who are doing so.
The Pennsylvania Patient and Provider Network or P3N, under the auspices of the Pennsylvania Department of Human Services, facilitates the secure sharing of patient information across a larger geographic area. While in the early stage, going forward, P3N can provide the capability for an Advance Care Directive and POLST registry where information will be uploaded and accessed securely through a Health Information Exchange.
Updates will be provided as progress occurs.
POLST Training Program
The POLST training program has been presented in numerous areas of the state since 2014. We recognize the POLST Task Force for NEPA for having presented the course, under the direction of Dr. Rob Yanoshak, for the 13th time this month.
The course was recently presented in Pittsburgh by the Jewish Healthcare Foundation. In the below picture, Libby Moore, LSW DHCE, is leading a discussion on “How to Have a POLST Discussion”.
POLST Best Practice
A health care practitioner's verbal order for a POLST is effective from the date given without countersignature until the expiration of the period of countersignature if all of the following requirements are met:
The order is entered for a patient receiving care from a health care facility.
The order is documented on the POLST form and countersigned by the health care practitioner in accordance with any applicable laws and regulations governing the health care facility, including but not limited to a timeframe in which the order must be countersigned.
No law or regulation governing the health care facility establishes a time limit in which the order must be countersigned, and the order is countersigned by the health care practitioner within seven days.
A surrogate decision maker's verbal consent for a POLST is effective on the date all the following requirements are satisfied:
Obtaining the signature of the surrogate decision maker is not feasible in a timely manner.
The consent is documented on the POLST form by the health care facility in accordance with its policies and procedures.
The signature of the surrogate decision maker is obtained as soon as feasible.